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Residuum Muscle Activation During Gait in Individuals with Traditional and Osteomyoplastic Amputation

Kotamraju, Bhanu Prasad BTech; Commuri, Sesh PhD; Mai, A. PhD; Dionne, Carol P. PT, DPT, PhD, OCS, CERT, MD; Day, Jonathan CPO; Ertl, William J.J. MD

JPO: Journal of Prosthetics and Orthotics: October 2018 - Volume 30 - Issue 4 - p 207–213
doi: 10.1097/JPO.0000000000000207

Introduction In this case series, distal residuum muscle activation during self-paced, fast-paced, and load-carrying walking gaits was compared by traditional transtibial amputation (TTA) or transtibial osteomyoplastic amputation (TOA) approach.

Method The activities of the residual muscles (tibialis anterior [TA] and gastrocnemius [GA]) were recorded during the three types of gait that are typically encountered during work-related activities.

Results The study shows that there was substantial muscle activity in both the TA and the GA muscles of a TOA subject. On the other hand, the TA in TTA subjects did not show any appreciable activity during any of the gaits. Although the GA muscle in the intact lower limb was active in the late stance phase in both TOA and TTA subjects, this muscle was also active in the loading phase and in the early swing phase in both the groups. This GA activation occurs consistently with supporting the body weight during early stance and preparing the limb for the swing phase during the gait cycle.

Conclusions The results of this study lay the foundation for future studies that investigate the effect of muscle activity on the health of the residual transtibial limb.

BHANU PRASAD KOTAMRAJU, BTech; and SESH COMMURI, PhD, are affiliated with School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma.

A. MAI, PhD, is affiliated with Nalco Champion–An Ecolab Company, Sugar Land, Texas.

CAROL P. DIONNE, PT, DPT, PhD, OCS, CERT, MD, is affiliated with the Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.

JONATHAN DAY, CPO; and WILLIAM J.J. ERTL, MD, are affiliated with the Department of Orthopedic Surgery and Rehabilitation, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Description: Residual muscle activity in traditional and osteomyoplastic transtibial persons with amputation during varied walking tasks is presented in this case study. The walking tasks were designed to emulate normal work-related activities so that the recorded muscle activations will be similar to those observed during normal daily activity of the subjects. The results show that the residual tibialis anterior remains inactive in persons with traditional amputation during these tasks, whereas it is active in individuals with osteomyoplastic amputation. The residual gastrocnemius, although active, deviates from the regular activation pattern of an intact limb in both the cases.

Statement of Submission: The authors have read and approved the following article for submission. The authors confirm that the manuscript has not been published before and is not being considered for publication elsewhere in whole or in part in any language except as an abstract.

Disclosure: The authors declare no conflict of interest.

This study was supported by a grant from the Office of the Vice President for Research at the University of Oklahoma Health Sciences (Translation Research Program; Carol Dionne, principal investigator).

Correspondence to: Sesh Commuri, PhD, School of Electrical and Computer Engineering, University of Oklahoma, Devon Energy Hall, 110 W Boyd St, DEH 432, Norman, OK 73019; email:

© 2018 by the American Academy of Orthotists and Prosthetists.